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The Association of Prenatal Diagnoses with Mortality and Long-Term Morbidity in Children with Specific Isolated Congenital Anomalies: A European Register-Based Cohort Study

Anna Heino Orcid Logo, Joan K. Morris, Ester Garne, Silvia Baldacci, Ingeborg Barisic, Clara Cavero-Carbonell, Laura García-Villodre, Joanne Given, Sue Jordan Orcid Logo, Maria Loane, L. Renée Lutke, Amanda J. Neville, Michele Santoro, Ieuan Scanlon, Joachim Tan, Hermien E. K. de Walle, Sonja Kiuru-Kuhlefelt, Mika Gissler

Maternal and Child Health Journal, Volume: 28, Issue: 6, Pages: 1020 - 1030

Swansea University Authors: Sue Jordan Orcid Logo, Ieuan Scanlon

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DOI (Published version): 10.1007/s10995-024-03911-9

Abstract

ObjectivesTo compare 5-year survival rate and morbidity in children with spina bifida, transposition of great arteries (TGA), congenital diaphragmatic hernia (CDH) or gastroschisis diagnosed prenatally with those diagnosed postnatally.MethodsPopulation-based registers’ data were linked to hospital a...

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Published in: Maternal and Child Health Journal
ISSN: 1092-7875 1573-6628
Published: Springer Science and Business Media LLC 2024
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URI: https://cronfa.swan.ac.uk/Record/cronfa65965
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Children with CDH had the highest infant mortality rate with a significant difference (p &lt; 0.001) between those prenatally (359/1,000 births) and postnatally (116/1,000) diagnosed. For all four anomalies, the median length of hospital stay was significantly greater in children with a prenatal diagnosis than those postnatally diagnosed. Children with prenatally diagnosed spina bifida (79% vs 60%; p = 0.002) were more likely to have surgery in the first week of life, with an indication that this also occurred in children with CDH (79% vs 69%; p = 0.06).ConclusionsOur findings do not show improved outcomes for prenatally diagnosed infants. For conditions where prenatal diagnoses were associated with greater mortality and morbidity, the findings might be attributed to increased detection of more severe anomalies. The increased mortality and morbidity in those diagnosed prenatally may be related to the lower mean gestational age (GA) at birth, leading to insufficient surfactant for respiratory effort. This is especially important for these four groups of children as they have to undergo anaesthesia and surgery shortly after birth. 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Renée</firstname><surname>Lutke</surname><order>11</order></author><author><firstname>Amanda J.</firstname><surname>Neville</surname><order>12</order></author><author><firstname>Michele</firstname><surname>Santoro</surname><order>13</order></author><author><firstname>Ieuan</firstname><surname>Scanlon</surname><order>14</order></author><author><firstname>Joachim</firstname><surname>Tan</surname><order>15</order></author><author><firstname>Hermien E. K. de</firstname><surname>Walle</surname><order>16</order></author><author><firstname>Sonja</firstname><surname>Kiuru-Kuhlefelt</surname><order>17</order></author><author><firstname>Mika</firstname><surname>Gissler</surname><order>18</order></author></authors><documents><document><filename>65965__29929__2e8a82e670a248c68e7ce3e67babcc8c.pdf</filename><originalFilename>65965.pdf</originalFilename><uploaded>2024-04-05T08:23:43.7516756</uploaded><type>Output</type><contentLength>697464</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.</documentNotes><copyrightCorrect>false</copyrightCorrect><language>eng</language><licence>https://creativecommons.org/licenses/by/4.0/</licence></document></documents><OutputDurs/></rfc1807>
spelling v2 65965 2024-04-04 The Association of Prenatal Diagnoses with Mortality and Long-Term Morbidity in Children with Specific Isolated Congenital Anomalies: A European Register-Based Cohort Study 24ce9db29b4bde1af4e83b388aae0ea1 0000-0002-5691-2987 Sue Jordan Sue Jordan true false 9fcb224c6bd804a4d41a2a8570a71185 Ieuan Scanlon Ieuan Scanlon true false 2024-04-04 HSOC ObjectivesTo compare 5-year survival rate and morbidity in children with spina bifida, transposition of great arteries (TGA), congenital diaphragmatic hernia (CDH) or gastroschisis diagnosed prenatally with those diagnosed postnatally.MethodsPopulation-based registers’ data were linked to hospital and mortality databases.ResultsChildren whose anomaly was diagnosed prenatally (n = 1088) had a lower mean gestational age than those diagnosed postnatally (n = 1698) ranging from 8 days for CDH to 4 days for TGA. Children with CDH had the highest infant mortality rate with a significant difference (p < 0.001) between those prenatally (359/1,000 births) and postnatally (116/1,000) diagnosed. For all four anomalies, the median length of hospital stay was significantly greater in children with a prenatal diagnosis than those postnatally diagnosed. Children with prenatally diagnosed spina bifida (79% vs 60%; p = 0.002) were more likely to have surgery in the first week of life, with an indication that this also occurred in children with CDH (79% vs 69%; p = 0.06).ConclusionsOur findings do not show improved outcomes for prenatally diagnosed infants. For conditions where prenatal diagnoses were associated with greater mortality and morbidity, the findings might be attributed to increased detection of more severe anomalies. The increased mortality and morbidity in those diagnosed prenatally may be related to the lower mean gestational age (GA) at birth, leading to insufficient surfactant for respiratory effort. This is especially important for these four groups of children as they have to undergo anaesthesia and surgery shortly after birth. Appropriate prenatal counselling about the time and mode of delivery is needed. Journal Article Maternal and Child Health Journal 28 6 1020 1030 Springer Science and Business Media LLC 1092-7875 1573-6628 Congenital diaphragmatic hernia; Gastroschisis; Prenatal diagnosis; Spina bifida; Transposition of great arteries 1 6 2024 2024-06-01 10.1007/s10995-024-03911-9 COLLEGE NANME Health and Social Care School COLLEGE CODE HSOC Swansea University Another institution paid the OA fee Horizon 733001 2024-07-15T11:37:17.9227739 2024-04-04T16:18:18.5415988 Faculty of Medicine, Health and Life Sciences School of Health and Social Care - Nursing Anna Heino 0000-0002-4168-4520 1 Joan K. Morris 2 Ester Garne 3 Silvia Baldacci 4 Ingeborg Barisic 5 Clara Cavero-Carbonell 6 Laura García-Villodre 7 Joanne Given 8 Sue Jordan 0000-0002-5691-2987 9 Maria Loane 10 L. Renée Lutke 11 Amanda J. Neville 12 Michele Santoro 13 Ieuan Scanlon 14 Joachim Tan 15 Hermien E. K. de Walle 16 Sonja Kiuru-Kuhlefelt 17 Mika Gissler 18 65965__29929__2e8a82e670a248c68e7ce3e67babcc8c.pdf 65965.pdf 2024-04-05T08:23:43.7516756 Output 697464 application/pdf Version of Record true This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. false eng https://creativecommons.org/licenses/by/4.0/
title The Association of Prenatal Diagnoses with Mortality and Long-Term Morbidity in Children with Specific Isolated Congenital Anomalies: A European Register-Based Cohort Study
spellingShingle The Association of Prenatal Diagnoses with Mortality and Long-Term Morbidity in Children with Specific Isolated Congenital Anomalies: A European Register-Based Cohort Study
Sue Jordan
Ieuan Scanlon
title_short The Association of Prenatal Diagnoses with Mortality and Long-Term Morbidity in Children with Specific Isolated Congenital Anomalies: A European Register-Based Cohort Study
title_full The Association of Prenatal Diagnoses with Mortality and Long-Term Morbidity in Children with Specific Isolated Congenital Anomalies: A European Register-Based Cohort Study
title_fullStr The Association of Prenatal Diagnoses with Mortality and Long-Term Morbidity in Children with Specific Isolated Congenital Anomalies: A European Register-Based Cohort Study
title_full_unstemmed The Association of Prenatal Diagnoses with Mortality and Long-Term Morbidity in Children with Specific Isolated Congenital Anomalies: A European Register-Based Cohort Study
title_sort The Association of Prenatal Diagnoses with Mortality and Long-Term Morbidity in Children with Specific Isolated Congenital Anomalies: A European Register-Based Cohort Study
author_id_str_mv 24ce9db29b4bde1af4e83b388aae0ea1
9fcb224c6bd804a4d41a2a8570a71185
author_id_fullname_str_mv 24ce9db29b4bde1af4e83b388aae0ea1_***_Sue Jordan
9fcb224c6bd804a4d41a2a8570a71185_***_Ieuan Scanlon
author Sue Jordan
Ieuan Scanlon
author2 Anna Heino
Joan K. Morris
Ester Garne
Silvia Baldacci
Ingeborg Barisic
Clara Cavero-Carbonell
Laura García-Villodre
Joanne Given
Sue Jordan
Maria Loane
L. Renée Lutke
Amanda J. Neville
Michele Santoro
Ieuan Scanlon
Joachim Tan
Hermien E. K. de Walle
Sonja Kiuru-Kuhlefelt
Mika Gissler
format Journal article
container_title Maternal and Child Health Journal
container_volume 28
container_issue 6
container_start_page 1020
publishDate 2024
institution Swansea University
issn 1092-7875
1573-6628
doi_str_mv 10.1007/s10995-024-03911-9
publisher Springer Science and Business Media LLC
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str School of Health and Social Care - Nursing{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}School of Health and Social Care - Nursing
document_store_str 1
active_str 0
description ObjectivesTo compare 5-year survival rate and morbidity in children with spina bifida, transposition of great arteries (TGA), congenital diaphragmatic hernia (CDH) or gastroschisis diagnosed prenatally with those diagnosed postnatally.MethodsPopulation-based registers’ data were linked to hospital and mortality databases.ResultsChildren whose anomaly was diagnosed prenatally (n = 1088) had a lower mean gestational age than those diagnosed postnatally (n = 1698) ranging from 8 days for CDH to 4 days for TGA. Children with CDH had the highest infant mortality rate with a significant difference (p < 0.001) between those prenatally (359/1,000 births) and postnatally (116/1,000) diagnosed. For all four anomalies, the median length of hospital stay was significantly greater in children with a prenatal diagnosis than those postnatally diagnosed. Children with prenatally diagnosed spina bifida (79% vs 60%; p = 0.002) were more likely to have surgery in the first week of life, with an indication that this also occurred in children with CDH (79% vs 69%; p = 0.06).ConclusionsOur findings do not show improved outcomes for prenatally diagnosed infants. For conditions where prenatal diagnoses were associated with greater mortality and morbidity, the findings might be attributed to increased detection of more severe anomalies. The increased mortality and morbidity in those diagnosed prenatally may be related to the lower mean gestational age (GA) at birth, leading to insufficient surfactant for respiratory effort. This is especially important for these four groups of children as they have to undergo anaesthesia and surgery shortly after birth. Appropriate prenatal counselling about the time and mode of delivery is needed.
published_date 2024-06-01T11:37:17Z
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